Provider Network Administration Specialist

Job Summary

Supporting provider lifecycle management operations, the full-time Senior Specialist in Provider Network Administration will manage data analysis, reporting, and workflow optimization while collaborating with various stakeholders to enhance provider data quality and operational performance.

Key responsibilities

• Assists in requirement gathering and training users in Salesforce while creating training manuals
• Generates and prepares provider-related data and reports to ensure accuracy in provider information systems
• Audits provider records for quality and financial accuracy, providing documented feedback and support for network administration projects

Required qualifications

• At least 4 years of healthcare experience, including claims, provider services, or provider network operations
• Claims processing experience, including coordination of benefits and eligibility criteria
• Familiarity with medical terminology and coding (CPT, ICD-9/ICD-10)
• Proficiency in Microsoft Office Suite, particularly intermediate Excel skills
• Strong data entry and processing skills with attention to detail